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How Rehospitalization Impacts The Healthcare System

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Rehospitalization occurs when a patient who had previously been discharged from the hospital is admitted again within a specific time period from the first admission. This is often also known as readmission to the hospital and readmission rates are an important measure in the US healthcare system. Rehospitalization impacts healthcare providers, patients and families.

Readmission Is a Hospital Quality Measure

The Hospital Readmission Reduction Program (HRRP) was designed as a Medicare value-based purchasing program that decreases payments to hospitals that have disproportionately high readmission rates. The program was created to encourage hospitals to improve communication and coordination of care to engage patients and caregivers in the discharge plan to prevent avoidable readmissions.

Readmissions Negatively Impact Patients and Families

First and foremost, readmission to the hospital can hurt patients and families because of the stressful situation it puts them in. Hospital stays can be costly to patients and families, especially when there are multiple stays. It is a physically and emotionally exhausting experience to be at a hospital and move from different facilities. Readmission may also reflect poor care coordination or inadequate recognition of post-discharge needs for a patient, especially if it is within the first few days. Readmissions that occur later are typically due to the underlying severity of a patient or events that are not in the control of the hospital.

Readmission Rates Negatively Impact Hospital Systems

Disproportionately high readmission rates are detrimental to hospital systems because they can hurt the reputation of the hospital, reduce profitability and contribute to overcrowding.  

Reputation

Hospitals are required to report all readmissions to the Centers for Medicare and Medicaid Services (CMS). Hospital quality measures are made public and can be found on the Care Compare tool from Medicare. Transparency through public reporting is an incentive to reduce readmission rates to keep up a healthcare providers reputation. Hospitals with high readmission rates may experience a diminished reputation and lead to a loss in patient volume.

Profitability

Hospitals are penalized through the CMS Readmission Reduction Program for having excess readmission rates. Readmissions negatively impact hospital profitability because they receive up to a 3% payment reduction penalty for each readmission. Hospitals with high readmission rates may also defer patients from choosing them as their healthcare provider.

Overcrowding

Rehospitalization can also contribute to hospital overcrowding, placing increased pressure on licensed medical professionals to work long hours.

Home-Based Care Can Help Reduce Readmission Rates

One of the solutions to the readmission problem is home health care, home care and hospice services. Home health care offers a wide range of health care services performed in the home setting for an illness or injury. Home health is usually less expensive, more convenient and just as effective as the care provided in a hospital or skilled nursing facility. Home health care providers work closely with patients and families to offer an interdisciplinary approach to care addressing the individual needs of the patient. Home health organizes patient care activities and shares information with all participants concerned with a patient’s care. Improving coordination of care between settings can help reduce avoidable hospital readmissions. Hospitals are increasingly forming partnerships with home care agencies to help combat avoidable readmissions to the hospital setting.

If home health is not right for a patient, they may also benefit from other home-based care services such as home care or hospice services.

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